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Health Effects of Occupational and Environmental Exposures to Nuclear Power Plants: A Meta-Analysis and Meta-Regression. 核电站职业和环境暴露对健康的影响:元分析和元回归。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-18 DOI: 10.1007/s40572-024-00453-8
Ro-Ting Lin, Hathaichon Boonhat, Yu-Yu Lin, Sonja Klebe, Ken Takahashi

Purpose of review: Numerous epidemiological studies have shown increased health risks among workers and residents living near nuclear power plants exposed to radiation levels meeting regulatory dose limits. This study aimed to evaluate the association between radiation exposure and disease risks among these populations exposed to radiation levels meeting the current regulatory dose limits.

Recent findings: We searched four databases (Cochrane Library, PubMed, ScienceDirect, and Web of Science) for studies published before August 2023, screened eligible studies (inclusion and exclusion criteria based on population, exposure, comparator, and outcome framework), and collected data on exposure indicators and disease risks. We applied random-effects models of meta-analysis to estimate the pooled effects and meta-regression to assess the dose-response relationship (radiation dose rate for workers and distance for residents). We identified 47 studies, 13 with worker and 34 with resident samples, covering 175 nuclear power plants from 17 countries, encompassing samples of 480,623 workers and 7,530,886 residents. Workers had a significantly lower risk for all-cancer and a significantly higher risk for mesothelioma. Residents had significantly higher risks for all-cancer, thyroid cancer, and leukemia. Notably, children under 5 years old showed the highest risk for all-cancer. Our meta-regression showed a significantly positive dose-response relationship between cumulative dose of radiation exposure and risk for circulatory disease among workers. Our findings demonstrated higher risks for mesothelioma for workers and all-cancer, thyroid cancer, and leukemia for residents exposed to low-dose radiation from nuclear power plants. Some included studies did not adjust for cancer risk confounders, which could overestimate the association between radiation exposure and cancer risk and increase the risk of bias.

审查目的:大量流行病学研究表明,生活在核电厂附近的工人和居民暴露在符合监管剂量限制的辐射水平下,健康风险增加。本研究旨在评估这些暴露于符合当前监管剂量限值的辐射水平的人群中的辐照与疾病风险之间的关联:我们在四个数据库(Cochrane Library、PubMed、ScienceDirect 和 Web of Science)中检索了 2023 年 8 月之前发表的研究,筛选了符合条件的研究(基于人群、辐照、比较者和结果框架的纳入和排除标准),并收集了辐照指标和疾病风险的数据。我们采用随机效应荟萃分析模型来估算集合效应,并采用荟萃回归来评估剂量-反应关系(工人的辐射剂量率和居民的辐射距离)。我们确定了 47 项研究,其中 13 项涉及工人样本,34 项涉及居民样本,涵盖 17 个国家的 175 家核电厂,包括 480,623 名工人和 7,530,886 名居民样本。工人罹患所有癌症的风险明显较低,而罹患间皮瘤的风险则明显较高。居民患所有癌症、甲状腺癌和白血病的风险明显较高。值得注意的是,5 岁以下儿童患所有癌症的风险最高。我们的元回归结果显示,工人的累积辐照剂量与循环系统疾病风险之间存在明显的正剂量反应关系。我们的研究结果表明,工人罹患间皮瘤的风险较高,而受到核电站低剂量辐射的居民罹患全癌、甲状腺癌和白血病的风险较高。一些纳入的研究没有对癌症风险混杂因素进行调整,这可能会高估辐照与癌症风险之间的关联,并增加偏倚风险。
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引用次数: 0
Exposure to Synthetic Endocrine-Disrupting Chemicals in Relation to Maternal and Fetal Sex Steroid Hormones: A Scoping Review. 合成干扰内分泌的化学品暴露与母体和胎儿性类固醇激素的关系:范围综述》。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-22 DOI: 10.1007/s40572-024-00455-6
Megan C Hansel, Abigail M Rosenberg, Carolyn W Kinkade, Camila Capurro, Zorimar Rivera-Núñez, Emily S Barrett

Purpose of review: Many synthetic endocrine-disrupting chemicals (EDCs) are ubiquitous in the environment and highly detected among pregnant people. These chemicals may disrupt maternal and/or fetal sex steroid hormones, which are critical to pregnancy maintenance and fetal development. Here, we review the epidemiological literature examining prenatal exposure to common synthetic EDCs in relation to maternal and fetal sex steroid hormones.

Recent findings: We performed a literature search using PubMed, SCOPUS, and Embase, ultimately identifying 29 articles for full review. Phenols, parabens, and persistent organic pollutants generally showed inverse associations with androgens, estrogens, and progesterone. Phthalates and per-and polyfluoroalkyl substances tended to be inversely associated with progesterone, while evidence regarding androgens and estrogens was mixed. Inconsistent, but noteworthy, differences by fetal sex and timing of exposure/outcome were observed. Overall, the literature suggests EDCs may disrupt maternal and fetal sex steroid activity, though findings are mixed. Given the pervasive, high-volume production of these synthetic chemicals and the critical functions sex steroid hormones play during gestation, additional research is warranted.

审查目的:许多合成的干扰内分泌的化学物质(EDCs)在环境中无处不在,在孕妇中的检出率也很高。这些化学物质可能会干扰母体和/或胎儿的性类固醇激素,而这些激素对妊娠维持和胎儿发育至关重要。在此,我们回顾了流行病学文献,研究了产前接触常见合成 EDC 与母体和胎儿性类固醇激素的关系:我们使用 PubMed、SCOPUS 和 Embase 进行了文献检索,最终确定了 29 篇文章进行全面审查。酚类、对羟基苯甲酸酯类和持久性有机污染物通常与雄激素、雌激素和孕酮呈反向关系。邻苯二甲酸盐和全氟及多氟烷基物质与孕酮呈反向关系,而雄激素和雌激素方面的证据则不尽相同。根据胎儿性别和接触时间/结果,观察到了不一致但值得注意的差异。总体而言,文献表明 EDC 可能会干扰母体和胎儿的性类固醇活性,但研究结果不一。鉴于这些合成化学物质的普遍、大量生产以及性类固醇激素在妊娠期间发挥的关键作用,有必要开展更多的研究。
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引用次数: 0
Advancing Understanding of Chemical Exposures and Maternal-child Health Through the U.S. Environmental Influences on Child Health Outcomes (ECHO) Program: A Scoping Review. 通过美国环境对儿童健康结果的影响 (ECHO) 计划促进对化学品暴露和母婴健康的了解:范围审查》。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-10 DOI: 10.1007/s40572-024-00456-5
Emily S Barrett, Jennifer L Ames, Stephanie M Eick, Alicia K Peterson, Zorimar Rivera-Núñez, Anne P Starling, Jessie P Buckley

Purpose of review: Environmental chemical exposures may disrupt child development, with long-lasting health impacts. To date, U.S. studies of early environmental exposures have been limited in size and diversity, hindering power and generalizability. With harmonized data from over 60,000 participants representing 69 pregnancy cohorts, the National Institutes of Health's Environmental influences on Child Health Outcomes (ECHO) Program is the largest study of U.S. children's health. Here, we: (1) review ECHO-wide studies of chemical exposures and maternal-child health; and (2) outline opportunities for future research using ECHO data.

Recent findings: As of early 2024, in addition to over 200 single-cohort (or award) papers on chemical exposures supported by ECHO, ten collaborative multi-cohort papers have been made possible by ECHO data harmonization and new data collection. Multi-cohort papers have examined prenatal exposure to per- and polyfluoroalkyl substances (PFAS), phthalates, phenols and parabens, organophosphate esters (OPEs), metals, melamine and aromatic amines, and emerging contaminants. They have primarily focused on describing patterns of maternal exposure or examining associations with maternal and infant outcomes; fewer studies have examined later child outcomes (e.g., autism) although follow up of enrolled ECHO children continues. The NICHD's Data and Specimen Hub (DASH) database houses extensive ECHO data including over 470,000 chemical assay results and complementary data on priority outcome areas (pre, peri-, and postnatal, airway, obesity, neurodevelopment, and positive health), making it a rich resource for future analyses. ECHO's extensive data repository, including biomarkers of chemical exposures, can be used to advance our understanding of environmental influences on children's health. Although few published studies have capitalized on these unique harmonized data to date, many analyses are underway with data now widely available.

审查目的:暴露于环境化学物质可能会扰乱儿童的发育,并对健康产生长期影响。迄今为止,美国对早期环境暴露的研究在规模和多样性方面都很有限,这阻碍了研究的有效性和普遍性。美国国立卫生研究院的环境对儿童健康结果的影响 (ECHO) 计划拥有来自 69 个妊娠队列的 60,000 多名参与者的统一数据,是美国最大的儿童健康研究。在此,我们(在此,我们将:(1)回顾整个 ECHO 计划中有关化学品暴露和母婴健康的研究;(2)概述利用 ECHO 数据开展未来研究的机会:截至 2024 年初,除了由 ECHO 支持的 200 多篇关于化学品暴露的单队列(或获奖)论文外,ECHO 数据协调和新数据收集工作还促成了 10 篇多队列合作论文。多队列论文研究了全氟和多氟烷基物质 (PFAS)、邻苯二甲酸盐、苯酚和对羟基苯甲酸酯、有机磷酸酯 (OPE)、金属、三聚氰胺和芳香胺以及新兴污染物的产前暴露。这些研究主要侧重于描述母体暴露模式或研究与母婴结果的关联;尽管对 ECHO 儿童的跟踪研究仍在继续,但对儿童后期结果(如自闭症)的研究较少。国家儿童疾病预防控制中心的数据和样本中心(DASH)数据库拥有大量的 ECHO 数据,包括超过 470,000 项化学检测结果以及优先结果领域(产前、围产期和产后、气道、肥胖、神经发育和积极健康)的补充数据,为未来的分析提供了丰富的资源。ECHO 广泛的数据存储库(包括化学暴露的生物标记)可用于促进我们对环境对儿童健康影响的了解。尽管迄今为止利用这些独特的统一数据进行的公开研究很少,但许多分析工作正在进行中,数据现已广泛提供。
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引用次数: 0
Methods for the Analysis of Multiple Epigenomic Mediators in Environmental Epidemiology. 环境流行病学中多种表观基因组媒介的分析方法。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-22 DOI: 10.1007/s40572-024-00436-9
Arce Domingo-Relloso, Maria Tellez-Plaza, Linda Valeri

Purpose of review: Epigenetic changes can be highly influenced by environmental factors and have in turn been proposed to influence chronic disease. Being able to quantify to which extent epigenomic processes are mediators of the association between environmental exposures and diseases is of interest for epidemiologic research. In this review, we summarize the proposed mediation analysis methods with applications to epigenomic data.

Recent findings: The ultra-high dimensionality and high correlations that characterize omics data have hindered the precise quantification of mediated effects. Several methods have been proposed to deal with mediation in high-dimensional settings, including methods that incorporate dimensionality reduction techniques to the mediation algorithm. Although important methodological advances have been conducted in the previous years, key challenges such as the development of sensitivity analyses, dealing with mediator-mediator interactions, including environmental mixtures as exposures, or the integration of different omic data should be the focus of future methodological developments for epigenomic mediation analysis.

综述的目的:表观遗传变化受环境因素的影响很大,进而被认为会影响慢性疾病。能够量化表观基因组过程在多大程度上是环境暴露与疾病之间关联的中介,是流行病学研究的兴趣所在。在这篇综述中,我们总结了应用于表观基因组数据的中介分析方法:omics数据的超高维度和高相关性阻碍了中介效应的精确量化。目前已提出了几种方法来处理高维环境下的中介效应,包括将降维技术纳入中介算法的方法。虽然前几年在方法学方面取得了重要进展,但一些关键挑战,如敏感性分析的开发、处理介导因子与介导因子之间的相互作用、将环境混合物作为暴露因子或整合不同的表观基因组介导分析方法,应成为未来表观基因组介导分析方法发展的重点。
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引用次数: 0
Opportunities and Challenges Associated with the Uptake of Residential Clean Fuel Usage. 住宅清洁燃料使用的机遇与挑战。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-03-12 DOI: 10.1007/s40572-024-00438-7
Darpan Das, Sohail Ahmad, Joshua Kirshner

Purpose of review: Almost 3 billion people worldwide use solid fuel for cooking and heating. This review examines (i) household energy practices and infrastructures and their influence on fuel usage in different contexts; (ii) barriers in adoption of household clean energy technologies and uses in diverse settings and population groups and (iii) potential air pollution exposure reduction in homes through using processed fuel.

Recent findings: Population health burden from solid fuel combustion-derived particulate air pollution has been estimated in several low- and middle-income countries. However, such studies have not been carried out in high income countries (e.g., UK). Irrespective of the region, fuel prices are the most dominant factor influencing the choice of fuel. Laboratory studies suggest processed fuel - pellets and briquettes - reduce particulate matter emissions by 70-80% and can be a promising alternative. Adoption of clean fuels for domestic energy needs facilitates progress towards five of the UN Sustainable Development Goals (SDGs). There is evidence that a variety of factors, including cost savings, encourage and hinder such uptake. These factors include price fluctuations, expenses, and the usage of clean fuels. Due to their distinct development scenarios, more expansive policy frameworks, and political economies of energy, these determinants are localized in character and differ significantly amongst economies. Therefore, in order to create innovative plans for the adoption of clean fuel use, strategies centred on local settings must be developed while keeping broad socio-technical and socio-economic issues in mind. Solid fuel processing - pelletization and briquetting - have the potential to reach Liquefied Petroleum Gas (LPG)-like emissions, and could be a potential strategy to mitigate exposure to household air pollution.

审查目的:全球有近 30 亿人使用固体燃料做饭和取暖。本综述研究了:(i) 家庭能源做法和基础设施及其在不同情况下对燃料使用的影响;(ii) 在不同环境和人口群体中采用家庭清洁能源技术和使用的障碍;(iii) 通过使用加工燃料减少家庭空气污染暴露的潜力:一些中低收入国家对固体燃料燃烧产生的微粒空气污染造成的人口健康负担进行了估算。然而,高收入国家(如英国)尚未开展此类研究。无论在哪个地区,燃料价格都是影响燃料选择的最主要因素。实验室研究表明,加工燃料--颗粒燃料和压块燃料--可减少 70-80% 的颗粒物排放,是一种很有前途的替代燃料。采用清洁燃料满足国内能源需求有助于在实现联合国可持续发展目标(SDGs)中的五项目标方面取得进展。有证据表明,包括节约成本在内的各种因素既鼓励也阻碍了清洁燃料的使用。这些因素包括价格波动、费用和清洁燃料的使用。由于各经济体的发展情景不同、政策框架更为宽泛以及能源政治经济的不同,这些决定因素都具有本地化的特点,而且在各经济体之间存在很大差异。因此,为了制定采用清洁燃料的创新计划,必须制定以当地环境为中心的战略,同时牢记广泛的社会技术和社会经济问题。固体燃料加工--造粒和压块--有可能达到液化石油气(LPG)的排放水平,可以成为减少家庭空气污染的潜在战略。
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引用次数: 0
Challenges of Air Pollution and Health in East Asia. 东亚空气污染与健康的挑战。
IF 7.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-07 DOI: 10.1007/s40572-024-00433-y
Xihao Du, Renjie Chen, Haidong Kan

Purpose of review: Air pollution has been a serious environmental and public health issue worldwide, particularly in Asian countries. There have been significant increases in epidemiological studies on fine particulate matter (PM2.5) and ozone pollution in East Asia, and an in-depth review of epidemiological evidence is urgent. Thus, we carried out a systematic review of the epidemiological research on PM2.5 and ozone pollution in East Asia released in recent years.

Recent findings: Recent studies have indicated that PM2.5 and ozone are the most detrimental air pollutants to human health, resulting in substantial disease burdens for Asian populations. Many epidemiological studies of PM2.5 and ozone have been mainly performed in three East Asian countries (China, Japan, and South Korea). We derived the following summary findings: (1) both short-term and long-term exposure to PM2.5 and ozone could raise the risks of mortality and morbidity, emphasizing the need for continuing improvements in air quality in East Asia; (2) the long-term associations between PM2.5 and mortality in East Asia are comparable to those observed in Europe and North America, whereas the short-term associations are relatively smaller in magnitude; and (3) further cohort and intervention studies are required to yield robust and precise evidence that can promote evidence-based policymaking in East Asia. This updated review presented an outline of the health impacts of PM2.5 and ozone in East Asia, which may be beneficial for the development of future regulatory policies and standards, as well as for designing subsequent investigations.

审查目的:空气污染一直是全球,尤其是亚洲国家的一个严重环境和公共卫生问题。东亚地区关于细颗粒物(PM2.5)和臭氧污染的流行病学研究明显增加,因此迫切需要对流行病学证据进行深入审查。因此,我们对近年来发布的东亚地区 PM2.5 和臭氧污染的流行病学研究进行了系统回顾:最近的研究表明,PM2.5 和臭氧是对人类健康最有害的空气污染物,给亚洲人口带来了巨大的疾病负担。许多关于 PM2.5 和臭氧的流行病学研究主要是在东亚三国(中国、日本和韩国)进行的。我们总结了以下结论:(1)短期和长期暴露于PM2.5和臭氧都会增加死亡和发病风险,这强调了在东亚持续改善空气质量的必要性;(2)在东亚,PM2.5与死亡率之间的长期关联与在欧洲和北美观察到的关联相当,而短期关联的程度相对较小;(3)需要进一步的队列研究和干预研究,以获得有力和准确的证据,从而促进东亚以证据为基础的决策。这篇最新综述概述了东亚 PM2.5 和臭氧对健康的影响,这可能有利于制定未来的监管政策和标准,以及设计后续调查。
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引用次数: 0
A Review of the Interactive Effects of Climate and Air Pollution on Human Health in China. 气候和空气污染对中国人体健康的交互影响综述》。
IF 7.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-13 DOI: 10.1007/s40572-024-00432-z
Meilin Yan, Tiantian Li

Purpose of review: Through a systematic search of peer-reviewed epidemiologic studies, we reviewed the literature on the human health impacts of climate and ambient air pollution, focusing on recently published studies in China. Selected previous literature is discussed where relevant in tracing the origins.

Recent findings: Climate variables and air pollution have a complex interplay in affecting human health. The bulk of the literature we reviewed focuses on the air pollutants ozone and fine particulate matter and temperatures (including hot and cold extremes). The interaction between temperature and ozone presented substantial interaction, but evidence about the interactive effects of temperature with other air pollutants is inconsistent. Most included studies used a time-series design, usually with daily mean temperature and air pollutant concentration as independent variables. Still, more needs to be studied about the co-occurrence of climate and air pollution. The co-occurrence of extreme climate and air pollution events is likely to become an increasing health risk in China and many parts of the world as climate changes. Climate change can interact with air pollution exposure to amplify risks to human health. Challenges and opportunities to assess the combined effect of climate variables and air pollution on human health are discussed in this review. Implications from epidemiological studies for implementing coordinated measures and policies for addressing climate change and air pollution will be critical areas of future work.

综述目的:通过对同行评审的流行病学研究进行系统检索,我们回顾了有关气候和环境空气污染对人类健康影响的文献,重点是最近在中国发表的研究。在追根溯源的过程中,我们还讨论了部分以前的相关文献:气候变量和空气污染在影响人类健康方面有着复杂的相互作用。我们查阅的大部分文献都侧重于空气污染物臭氧和细颗粒物以及温度(包括极端冷热)。温度与臭氧之间的相互作用呈现出实质性的相互作用,但温度与其他空气污染物之间的相互作用效应的证据并不一致。大多数纳入的研究都采用了时间序列设计,通常将日平均气温和空气污染物浓度作为自变量。不过,关于气候与空气污染的共存,还有更多需要研究的地方。随着气候变化,极端气候和空气污染事件的同时发生可能会对中国和世界许多地区的健康造成越来越大的威胁。气候变化会与空气污染暴露相互作用,扩大对人类健康的风险。本综述讨论了评估气候变量和空气污染对人类健康的综合影响所面临的挑战和机遇。流行病学研究对实施协调措施和政策以应对气候变化和空气污染的影响将是未来工作的关键领域。
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引用次数: 0
The Association Between Personal Air Pollution Exposures and Fractional Exhaled Nitric Oxide (FeNO): A Systematic Review. 个人空气污染暴露与呼出一氧化氮分数(FeNO)之间的关系:系统回顾。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-22 DOI: 10.1007/s40572-024-00430-1
Abhay Anand, Elliana Castiglia, Misti Levy Zamora

Purpose of review: Airway inflammation is a common biological response to many types of environmental exposures and can lead to increased nitric oxide (NO) concentrations in exhaled breath. In recent years, several studies have evaluated airway inflammation using fractional exhaled nitric oxide (FeNO) as a biomarker of exposures to a range of air pollutants. This systematic review aims to summarize the studies that collected personal-level air pollution data to assess the air pollution-induced FeNO responses and to determine if utilizing personal-level data resulted in an improved characterization of the relationship between air pollution exposures and FeNO compared to using only ambient air pollution exposure data.

Recent findings: Thirty-six eligible studies were identified. Overall, the studies included in this review establish that an increase in personal exposure to particulate and gaseous air pollutants can significantly increase FeNO. Nine out of the 12 studies reported statistically significant FeNO increases with increasing personal PM2.5 exposures, and up to 11.5% increase in FeNO per IQR increase in exposure has also been reported between FeNO and exposure to gas-phase pollutants, such as ozone, NO2, and benzene. Furthermore, factors such as chronic respiratory diseases, allergies, and medication use were found to be effect modifiers for air pollution-induced FeNO responses. About half of the studies that compared the effect estimates using both personal and ambient air pollution exposure methods reported that only personal exposure yielded significant associations with FeNO response. The evidence from the reviewed studies confirms that FeNO is a sensitive biomarker for air pollutant-induced airway inflammation. Personal air pollution exposure assessment is recommended to accurately assess the air pollution-induced FeNO responses. Furthermore, comprehensive adjustments for the potential confounding factors including the personal exposures of the co-pollutants, respiratory disease status, allergy status, and usage of medications for asthma and allergies are recommended while assessing the air pollution-induced FeNO responses.

综述的目的:气道炎症是对多种环境暴露的常见生物反应,可导致呼出气体中一氧化氮(NO)浓度增加。近年来,一些研究利用部分呼出一氧化氮(FeNO)作为暴露于一系列空气污染物的生物标志物,对气道炎症进行了评估。本系统综述旨在总结收集个人水平空气污染数据以评估空气污染引起的一氧化氮反应的研究,并确定与仅使用环境空气污染暴露数据相比,使用个人水平数据是否能更好地描述空气污染暴露与一氧化氮之间的关系:共确定了 36 项符合条件的研究。总体而言,纳入本综述的研究证实,个人暴露于颗粒物和气态空气污染物的增加会显著增加 FeNO。在 12 项研究中,有 9 项研究报告称,随着个人 PM2.5 暴露量的增加,FeNO 会出现统计学意义上的显著增加,而且有报告称,FeNO 与气相污染物(如臭氧、二氧化氮和苯)暴露量之间的关系是,暴露量每增加 IQR,FeNO 就会增加 11.5%。此外,慢性呼吸道疾病、过敏和药物使用等因素也被认为是空气污染引起的 FeNO 反应的效应调节因子。在使用个人和环境空气污染暴露方法比较效应估计值的研究中,约有一半的研究报告称,只有个人暴露与 FeNO 反应有显著关联。综述研究的证据证实, FeNO 是空气污染物诱发气道炎症的敏感生物标志物。建议进行个人空气污染暴露评估,以准确评估空气污染诱发的 FeNO 反应。此外,在评估空气污染诱导的 FeNO 反应时,建议对潜在的混杂因素进行全面调整,包括个人接触的共污染物、呼吸系统疾病状况、过敏状况以及哮喘和过敏药物的使用情况。
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引用次数: 0
The Health-Related and Learning Performance Effects of Air Pollution and Other Urban-Related Environmental Factors on School-Age Children and Adolescents-A Scoping Review of Systematic Reviews. 空气污染和其他城市环境因素对学龄儿童和青少年健康和学习成绩的影响--系统性综述的范围界定综述》(The Health-Related and Learning Performance Effects of Air Pollution and Other Urban-Related Environmental Factors on School-Age Children and Adolescent-A Scoping Review of Systematic Reviews)。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-19 DOI: 10.1007/s40572-024-00431-0
Inés Valls Roche, Mònica Ubalde-Lopez, Carolyn Daher, Mark Nieuwenhuijsen, Mireia Gascon

Purpose of review: This scoping review aims to assess the impact of air pollution, traffic noise, heat, and green and blue space exposures on the physical and cognitive development of school-age children and adolescents. While existing evidence indicates adverse effects of transport-related exposures on their health, a comprehensive scoping review is necessary to consolidate findings on various urban environmental exposures' effects on children's development.

Recent findings: There is consistent evidence on how air pollution negatively affects children's cognitive and respiratory health and learning performance, increasing their susceptibility to diseases in their adult life. Scientific evidence on heat and traffic noise, while less researched, indicates that they negatively affect children's health. On the contrary, green space exposure seems to benefit or mitigate these adverse effects, suggesting a potential strategy to promote children's cognitive and physical development in urban settings. This review underscores the substantial impact of urban exposures on the physical and mental development of children and adolescents. It highlights adverse health effects that can extend into adulthood, affecting academic opportunities and well-being beyond health. While acknowledging the necessity for more research on the mechanisms of air pollution effects and associations with heat and noise exposure, the review advocates prioritizing policy changes and urban planning interventions. This includes minimizing air pollution and traffic noise while enhancing urban vegetation, particularly in school environments, to ensure the healthy development of children and promote lifelong health.

审查目的:本范围界定综述旨在评估空气污染、交通噪声、热量以及绿色和蓝色空间暴露对学龄儿童和青少年身体和认知发展的影响。虽然现有证据表明与交通相关的暴露会对儿童的健康产生不利影响,但有必要进行一次全面的范围界定审查,以整合有关各种城市环境暴露对儿童发育影响的研究结果:有一致的证据表明,空气污染会对儿童的认知和呼吸系统健康以及学习成绩产生负面影响,增加他们成年后患病的几率。关于热量和交通噪音的科学证据虽然研究较少,但也表明它们会对儿童的健康产生负面影响。相反,接触绿地似乎有益于或减轻这些不利影响,这表明绿地是促进城市环境中儿童认知和身体发育的潜在策略。本综述强调了城市暴露对儿童和青少年身心发展的重大影响。它强调了对健康的不利影响,这种影响可能会延续到成年期,影响学业机会和健康以外的福祉。在承认有必要对空气污染的影响机制以及与热量和噪音暴露的关联性进行更多研究的同时,该报告提倡优先考虑政策变化和城市规划干预措施。这包括最大限度地减少空气污染和交通噪音,同时加强城市植被,特别是学校环境的植被,以确保儿童的健康成长,促进终生健康。
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引用次数: 0
Supporting Decarbonization of Health Systems-A Review of International Policy and Practice on Health Care and Climate Change. 支持医疗保健系统的去碳化--医疗保健与气候变化国际政策与实践回顾》(Supporting Decarbonization of Health Systems-A Review of International Policy and Practice on Health Care and Climate Change)。
IF 7.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-02-15 DOI: 10.1007/s40572-024-00434-x
Emily Hough, Arielle Cohen Tanugi-Carresse

Purpose of review: Healthcare is a significant contributor of carbon emissions, which contribute to climate change. There has been an increased focus on the role healthcare should play in reducing emissions in recent years. This review, completed in September and October 2022, explored national commitments among 73 countries to reduce emissions from healthcare and the policies and delivery plans that exist to support their implementation.

Recent findings: Whilst some countries such as Norway, Columbia, and Australia are working to understand current emissions and develop plans to reduce them, few have published delivery plans for meeting national targets. Broader policies and reports published to date provide a clear set of actions that healthcare can take to reduce emissions. However, more research, innovation, and service redesign will be needed to close the gap to net zero healthcare. Some health systems are already taking action to reduce their emissions. However, national incentives, including standardized metrics and reporting, can help drive broader action and pace of delivery.

审查目的:医疗保健是碳排放的重要来源,而碳排放会导致气候变化。近年来,人们越来越关注医疗保健在减排方面应发挥的作用。本次审查于 2022 年 9 月和 10 月完成,探讨了 73 个国家在减少医疗排放方面的国家承诺,以及支持其实施的现有政策和交付计划:虽然挪威、哥伦比亚和澳大利亚等国正在努力了解当前的排放量并制定减排计划,但很少有国家公布了实现国家目标的实施计划。迄今为止发布的更广泛的政策和报告提供了一套明确的医疗保健减排行动。然而,还需要更多的研究、创新和服务重新设计,才能缩小与净零医疗的差距。一些医疗系统已经在采取减排行动。然而,包括标准化指标和报告在内的国家激励措施可以帮助推动更广泛的行动和交付速度。
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引用次数: 0
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Current Environmental Health Reports
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